Lago, Holly J

Lago, Holly J is an individual health care provider with primary practice located at 1940 W Indian School Rd Ste 1 , Phoenix AZ 85015-5112. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Lago, Holly J can be contacted via phone (602) 782-1880.

Contact Information

Primary practice address
1940 W Indian School Rd Ste 1 Phoenix AZ 85015-5112
Phone: (602) 782-1880
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R134082-4 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2020040251 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 80303 Kansas

Profile Details

NPI number 1649240938
LBN Legal business name Lago, Holly J
Credentials C-FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Jun 5th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649240938 NPPES
Minnesota MEDICAID 886467500
Minnesota Other 13620
Minnesota Other 253254
Minnesota Other 281G0KO
Minnesota Other 974311045631
Minnesota Other 806278
Minnesota Other 0121785
Minnesota Other 135445
Minnesota Other 435M6KO
Minnesota MEDICAID 0599456
Minnesota Other 47358
Minnesota Other HP56828
Minnesota Other P00365643

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